‘My Eyes Were So Puffy I Was Unable to Even Unseal Them’

Onemanda Preisinger feels anxious about her child’s impending 13th birthday celebration. Not for the usual causes associated with a house full of clamorous preteen kids, but because it’s the first time she will showcase her new face to friends and relatives. “Obviously I’m going to tell everyone as they arrive, ‘For your information, this is not the way I look,’” states the 30-year-old property agent from south Florida.

How she looks is, admittedly, a somewhat surprising – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s keen to stress, temporary – look is the outcome of six aesthetic surgeries, such as an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My poor husband teared up when he saw me for the first time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she tells me via online call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a growing number of people electing to have a rhytidectomy in their 20s and 30s – well over a decade before typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the industry edict of: “We address genetics, not age.”) “I have 28-year-olds requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I observe people choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a facelift, elevates the tissues in the face that start to sag as we grow older. “Human faces are built a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that is what loosens and sags and pulls the dermis downward with it.”

You risk operating on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Previously reserved of affluent seniors, overuse of injectables – when excessive use of injectable gels stretches the face and causes laxity in the skin – combined with the common adoption of weight-loss drugs, low-cost medical tourism, and the advancement of novel, famous-figure-promoted surgical techniques are attracting a new kind of patient towards this major operation. Reports indicate an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a study revealed that the percentage of younger facelift patients is increasing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“People are now requesting to look like the best version of themselves and naturally the methods are following,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy entails lifting the superficial layer, the comprehensive lift loosens the facial ligaments underneath, enabling surgeons to reshape the face by repositioning the underlying layers, and preventing the tight, stretched appearance occasionally caused by older methods. “We’re not putting stress on the skin because we’re targeting deeper, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The dermis follows along as a passenger.” Elevating the whole facial structure as a single unit allows for a authentic-appearing and longer-lasting outcome. It also means that the surgery is not just being used for the primary goal of youth preservation – or revitalization, as the cosmetic field describes it – but for “beautification” and contouring, too. “We’re getting many inquiries from patients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on getting a facial lift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she says. “I did it because the filler ruined my face. I wish I had never done it. If I had avoided the filler, I don’t think I would be where I’m at currently.”

Whether injectable substances completely disappear has historically been a debated topic in the aesthetics industry. “Studies have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can block drainage pathways. A contributing factor to what we call ‘pillow face’ is also the fact that in a sense, the face gets slightly fluid-filled because its ability to remove lymphatic fluid has been reduced.” Though studies into the area is early-stage, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies initiated. An esteemed face specialist, commenting anonymously, says he would never use fillers in a client because of the risks they present. “Many doctors don’t want to talk about this, because the manufacturers who produce filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she had to keep replenishing it – particularly when it started to migrate to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a facial and neck surgery might be what she required to finally step off the injectable hamster wheel. Two years later, she ended up choosing between a list of suggested accommodations in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon recommended that a facial lift was the correct option for the laxity she was finding in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The eve of her operation, 24 hours post she’d touched down solo in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We will elevate the under-eye bags.’ Then he said, ‘I think if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|